Staff Developed Infection Prevention Program Increases Antimicrobial Stewardship and Deceases Hospital Acquired Infection Rates

Tuesday, 19 November 2013: 10:40 AM

Yousef Aljeesh, PhD, RN1
Said K. Abusalem, PhD, RN2
Naeem Alkariri, MSN, RN1
Fawwaz Alaloul, PhD, RN2
(1)School of Nursing, Islamic University of Gaza, Gaza, Palestine
(2)School of Nursing, University of Louisville, Louisville, KY

Learning Objective 1: Identiy quality assessment tools that help monitor outcomes in the ICU to guide the development of interventions

Learning Objective 2: Understand the importance of involving the health care team in quality improvement projects aimed at decreasing the rate of HAI and Antibiotics use.

The burden of Hospital Associated Infections (HAIs) in intensive care units is extremely high and cannot be overemphasized, with more than one third of all HAIs being acquired in intensive care units.  This study firstly aimed to involving the health care team in identifying causes of HAIs and antibiotic use, then involving the health care team in developing activities and interventions to improve the quality of health care in the intensive care unit (ICU) at Ranteesy Pediatric Hospital (RPH). The research team then evaluated the effectiveness of these interventions. 

The study design is Quasi experimental (pre and post-test), all the staff who worked in the intensive care unit were involved in this study.  The three phases of the project: assessing the preexisting stage, development and implementation of the interventions, and evaluating its effectiveness after 12 months. The researchers used many quality assessment tools to help identifying, collecting, displaying, monitoring, and improving the quality of health care.  These tools are Brainstorming, self-administered questionnaire, check list, flow charts, fish bone analysis, Pareto chart, trend chart, and run chart. 

Result revealed that lack of knowledge; supervision and experience were the mostly perceived causes of HAI in the ICU.  Post intervention tests showed statistical significant improvement and a decrease in the rate of HAIs in comparison to the pre-test, and the mean of positive cultures (blood, sputum, urine, wounds or CSF) decreased from 76% to 42%, used of antibiotics vials per week decreased from 130 to 92 vials, and the average hospital stay days from (8-10) to (5-8).  The study findings supported the need for health educational programs about infection control and prevention, and monitoring staff performance at RPH ICU in order to reduce the rate of HAIs and antibiotic use.